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PubMed2004

Identification of resected root-end dentinal cracks: a comparative study of transillumination and dyes.

The dilemma of diagnosing and possibly treating dentinal cracks continues to present a challenge in endodontics. The purpose of this in vitro study was to compare the effectiveness of transillumination and dyes in identifying root-end dentinal cracks. Fifty maxillary central incisors were decoronated, and the canals were instrumented to an ISO size 50 at the working length. The apical 3 mm of the roots was resected, and cracks were artificially created in the apical dentin. Four independent examiners evaluated the root ends at x8 magnification with a surgical operating microscope using transillumination (group 1), sodium fluorescein dye (group 2), caries detect dye (group 3), methylene blue dye (group 4), and methylene blue plus transillumination (group 5). The examiners' ability to identify root ends correctly with and without cracks was analyzed by comparing the data with the predetermined standard (cracked and noncracked) using logistic regression analysis. All techniques used were shown to be more effective than random chance at diagnosing cracks. The areas under the curve of the different techniques were as follows: transillumination, 0.81 (95% confidence interval [CI], 0.69-0.93); sodium fluorescein, 0.72 (95% CI, 0.58-0.86); caries detector, 0.76 (95% CI, 0.63-0.89); methylene blue, 0.70 (95% CI, 0.55-0.84); and methylene blue plus transillumination, 0.82 (95% CI, 0.70-0.94). Thus, the crack assessment techniques that gave the best discrimination between cracked and noncracked specimens, regardless of rater, was methylene blue plus transillumination. This study emphasizes the usefulness of transillumination along with magnification in detecting dentinal cracks.

Area Under Curve↗
PubMed2006

Resistance of three new esthetic post-and-core systems to compressive loading.

STATEMENT OF PROBLEM: Despite their esthetic properties, the fracture resistance of newly introduced esthetic post-and-core systems has not been studied, restricting clinical use. PURPOSE: The purpose of this study was to determine and compare the fracture resistances of 3 recently introduced esthetic post-and-core systems with a cast metal post and core using a clinically related test method. MATERIAL AND METHODS: Forty recently extracted caries-free maxillary central incisors were selected, sectioned, and their roots endodontically treated. The roots were then embedded in acrylic resin blocks and assigned to 4 experimental groups (n = 10). The cast metal (Wiron 99) post-and-core group (CMDC) served as the control. Three experimental groups consisted of a stainless steel post/composite-resin (Charisma) core group (SCOM), zirconium dioxide post/composite-resin (Charisma) core group (ZCOM), and zirconium dioxide post/ceramic (Cosmopost) core group (ZCER). The post spaces were prepared, posts were seated, cores were formed, and 40 post-and-core foundations were cemented into the roots. Following thermal cycling (5000 cycles between 5 degrees C and 55 degrees C with a dwell time of 30 seconds), a compressive load was applied to the inclined surface of each specimen at a 130-degree angle to the specimen long axes in a universal testing machine at a crosshead speed of 1 mm/min until failure occurred. Force to failure (N) was recorded. Data were analyzed with a 1-way analysis of variance and Bonferroni tests to determine the difference between the groups (alpha=.05). For pairwise comparisons among group mean values, P < .0083 indicated statistical significance and established the overall confidence level at 95%. RESULTS: Groups CMDC (738.6 N +/- 10.2) and ZCER (710.2 N +/- 5.3) exhibited the highest resistance to fracture. The ZCOM group showed the lowest fracture resistance (450.3 N +/- 5.7). The fracture resistance of the SCOM group (565 N +/- 7.2) was lower than the CMDC and ZCER groups, and higher than the ZCOM group. The differences among the groups were significant (P < .001) except for CMDC and ZCER (P < .016). CONCLUSION: Within the limitations of this study, the cast metal post/core and zirconia post/ceramic core foundations were found to be more fracture resistant than the zirconia post/composite-resin core and stainless steel post/composite-resin core foundations. Aside from its desirable esthetic properties, the zirconia post/ceramic core combination demonstrated high resistance to fracture.

Analysis of Variance↗
PubMed2006

Dentin dysplasia type I treated with onlay bone grafting, sinus augmentation, and osseointegrated implants.

Dentin dysplasia is a defect of dentin development that was classified by Shields as type I and type II. The teeth in dentin dysplasia type I are characterized by normal enamel and abnormal dentin in the crown and root. For that reason, this disorder is characterized by dental caries, early exfoliation of the teeth and, consequently, maxillomandibular bony atrophy. In this report, we present a case of a young girl affected by dentin dysplasia type I, treated with a combination of onlay bone grafting and a sinus lift technique to accomplish implant placement. This case showed that onlay autogenous grafting and a sinus lift technique are well-tested methods of bony augmentation and can be useful in patients with congenital dentin defects, such as dentin dysplasia.

Adult↗
PubMed1992

Infantile osteopetrosis: a case report on dental findings.

In this paper we have described the case of a 7-yr-old Moroccan osteopetrotic boy, who had received a bone marrow transplant (BMT). He was transplanted from his older brother and, despite immunosuppressive therapy, developed chronic graft-versus-host disease and was placed on corticotherapy. Seven months after the bone marrow transplant, graft versus host disease (GVHD) was stabilized, but corticotherapy had inhibited growth. There was evidence of normalizing bone, his hearing was better but he had not recovered vision. Dental findings before the bone marrow transplant revealed some missing teeth, failure of teeth to erupt and decayed teeth but no enamel hypoplasia. The patient had developed one carious lesion on one unerupted tooth: bacteria seem to have found a way through the gubernaculum dentale. The scanning electronmicrographs showed decayed tooth and tissues fitted into each other. Since the bone marrow transplant, no tooth has erupted. We think that, in this case, failure of tooth eruption would be the sign of osteopetrosis.

Bone Marrow Transplantation↗
PubMed2004

Unusual maxillary lateral incisors: case reports.

Root canal morphology is often complex and the number of root canals may vary for any type of tooth. Abnormalities in the root canal morphology of maxillary lateral inciors are rare. Maxillary lateral incisors can have two root canals, even though the dental literature supports their 100% single-canal anatomy. It is vital to consider the possibility of extra root canal(s), even in teeth with a low frequency of abnormal root canal anatomy. This report presents two cases of maxillary lateral incisors with two root canals.

Adult↗
PubMed2000

Prospects for applying fluorescence spectroscopy to diagnose the hard tissues of a tooth.

This article deals with the autofluorescence spectra from the hard tissues of a tooth, both in norm and pathology. An investigation was made on 30 extracted human teeth. The measurements were made both for the intact hard tissues of a tooth, such as enamel, dentine, cementum, and root canal, and for the tissues pathologically affected by a caries (superficial, intermediate, and deep) and by a dental calculus. It was found that the fluorescent spectra from enamel, dentine, cementum, and from the regions affected by a caries and dental calculus were identical in form. All the spectra revealed a maximum near 700 nm. However, the intact and affected hard tissues were greatly different in the integral fluorescent intensity. Dental calculus was found to produce the most pronounced fluorescent intensity, whereas the carious regions produced a slightly weaker fluorescent intensity. On the contrary, the intact hard tissues of a tooth exhibited the poorest fluorescent intensity.

Biophysical Phenomena↗
PubMed1990

Oral complications of cancer therapies. Chronic dental complications.

Radiation therapy (RT) and chemotherapy have increased long-term survival with certain cancers. The use of dental investigation and treatment of chronic or delayed oral complications is developing. Altered dental root development, enamel opacities, hypocalcifications, periodontal problems, and a higher caries rate are seen in children treated with chemotherapy. The psychosocial implications of long-term survival on routine dental care are important. Prevention and treatment of long-term oral complications of radiation therapy are changing. Osteoradionecrosis remains complicated and devastating. Strategies that avoid post-RT extractions include caries prevention, oral hygiene measures, meticulous restorative dentistry, overdentures, and improved posts for endodontically treated teeth. Guidelines for post-RT extractions vary greatly. Pediatric patients who receive head and neck irradiation may have total arrest of tooth and jaw development within the portal. The dentist must be able to diagnose and treat the variety of alterations already identified and should engage in scholarly research to answer the questions that remain.

Antineoplastic Agents↗